Difference between revisions of "American Reinvestment Act of 2009"
| Line 4: | Line 4: | ||
It is to be noted that President Bush, in 2004, through an Executive Order, first tasked the nation with a 10 year mandate to embrace EMRs and also created the Office of the National Coordinator (ONC) to oversee this massive initiative. | It is to be noted that President Bush, in 2004, through an Executive Order, first tasked the nation with a 10 year mandate to embrace EMRs and also created the Office of the National Coordinator (ONC) to oversee this massive initiative. | ||
| − | == | + | == Legislation == |
The legislation consists of two (2) parts. (1) To preserve and create jobs and promote economic recovery. (2) To assist those most impacted by the recession. (3) To provide investments needed to increase economic efficiency by spurring technological advances in science and health. (4) To invest in transportation, environmental protection, and other infrastructure that will provide long-term economic benefits. (5) To stabilize State and local government budgets, in order to minimize and avoid reductions in essential services and counterproductive state and local tax increases | The legislation consists of two (2) parts. (1) To preserve and create jobs and promote economic recovery. (2) To assist those most impacted by the recession. (3) To provide investments needed to increase economic efficiency by spurring technological advances in science and health. (4) To invest in transportation, environmental protection, and other infrastructure that will provide long-term economic benefits. (5) To stabilize State and local government budgets, in order to minimize and avoid reductions in essential services and counterproductive state and local tax increases | ||
| Line 56: | Line 56: | ||
Total health care spending: $155.1 billion. | Total health care spending: $155.1 billion. | ||
| − | In her article dated 1/5/2015, on iHealthBeat.org, a daily publication of California Health Foundation, "12 experts weigh in on HIT progress, disappointments in 2014 and hopes for 2015", Kate Ackerman, Editor in Chief points out that, | + | In her article dated 1/5/2015, on iHealthBeat.org, a daily publication of California Health Foundation, "12 experts weigh in on HIT progress, disappointments in 2014 and hopes for 2015", Kate Ackerman, Editor in Chief points out that <ref name="ackerman 2015"> 12 Experts Weigh In on Health IT Progress, Disappointment in 2014 & Hopes for 2015. January 5, 2015. http://www.ihealthbeat.org/insight/2015/12-experts-weigh-in-on-health-it-progress-disappointment-in-2014-hopes-for-2015</ref> |
| − | "Incentive payments for eligible hospitals and professionals participating in the meaningful use program reached $25.7 B in 2014". | + | <blockquote>"Incentive payments for eligible hospitals and professionals participating in the meaningful use program reached $25.7 B in 2014".</blockquote> |
| − | She goes on to add | + | She goes on to add: |
| − | + | <blockquote>"According to ONC, more than 93% of eligible hospitals and 76% of eligible professionals now meaningfully use Health IT". <ref name="ackerman 2015"></ref> Although the 10 year Presidential mandate has included all three stages, we can reasonably infer that Stage-I - "Adoption" has been successful.</blockquote> | |
| − | == | + | She also states that |
| + | |||
| + | <blockquote>"However, at the end of the year, CMS announced that more than 257,000 eligible professionals will be penalized in 2015 for failing to meet Medicare meaningful use requirements". <ref name="ackerman 2015"></ref></blockquote> | ||
| + | |||
| + | This is a clear indication that, the Government, while willing and able to provide financial incentives for those that comply with this mandate, will also not hesitate to penalize those that don't comply, thereby making it both affordable and necessary for the well being of the society. | ||
| + | |||
| + | == Health Information Technology == | ||
Medicare and Medicaid EHR Incentive Program will provide incentive payments to eligible professionals (EP), eligible hospitals (EH) and critical access hospitals (CAH) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. | Medicare and Medicaid EHR Incentive Program will provide incentive payments to eligible professionals (EP), eligible hospitals (EH) and critical access hospitals (CAH) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. | ||
| Line 72: | Line 78: | ||
As enacted in 2009, mental health treatment facilities were excluded from the financial incentives available to most hospitals. The Behavioral Health Information Technology Act of 2011 extended the HITECH definition of “provider” and “facility” to include those for behavioral and mental health care. This incentivized proliferation of interoperable health information technology across psychiatric and primary health where continuity is vital. [https://www.aacap.org/App_Themes/AACAP/docs/Advocacy/federal_and_state_initiatives/health_care_reform/aacap_policy_summary_on_health_information_technology.pdf] | As enacted in 2009, mental health treatment facilities were excluded from the financial incentives available to most hospitals. The Behavioral Health Information Technology Act of 2011 extended the HITECH definition of “provider” and “facility” to include those for behavioral and mental health care. This incentivized proliferation of interoperable health information technology across psychiatric and primary health where continuity is vital. [https://www.aacap.org/App_Themes/AACAP/docs/Advocacy/federal_and_state_initiatives/health_care_reform/aacap_policy_summary_on_health_information_technology.pdf] | ||
| − | + | == Resources == | |
| + | <references/> | ||
http://www.hhs.gov/recovery/overview/index.html | http://www.hhs.gov/recovery/overview/index.html | ||
| Line 89: | Line 96: | ||
https://www.aacap.org/App_Themes/AACAP/docs/Advocacy/federal_and_state_initiatives/health_care_reform/aacap_policy_summary_on_health_information_technology.pdf | https://www.aacap.org/App_Themes/AACAP/docs/Advocacy/federal_and_state_initiatives/health_care_reform/aacap_policy_summary_on_health_information_technology.pdf | ||
| − | |||
| − | |||
Revision as of 07:53, 27 January 2015
This policy was enacted in 2009 to mandate implementation of EMR technology across the country. The mandate encouraged health care providers to invest in EMR technology and provides financial incentives to providers who participate. United States American Reinvestment Act of 2009, which is a complex economic stimulus package written during the administration of George W Bush (43rd President of the United States of America) and signed into law by Barack H Obama (44th President of the United States of America) is the funding and legislative vehicle to instigate economic development, job creation and address the implementation of EMR electronic medical record (EMR) technology that has not been implemented to this point.
It is to be noted that President Bush, in 2004, through an Executive Order, first tasked the nation with a 10 year mandate to embrace EMRs and also created the Office of the National Coordinator (ONC) to oversee this massive initiative.
Contents
Legislation
The legislation consists of two (2) parts. (1) To preserve and create jobs and promote economic recovery. (2) To assist those most impacted by the recession. (3) To provide investments needed to increase economic efficiency by spurring technological advances in science and health. (4) To invest in transportation, environmental protection, and other infrastructure that will provide long-term economic benefits. (5) To stabilize State and local government budgets, in order to minimize and avoid reductions in essential services and counterproductive state and local tax increases
DIVISION A—APPROPRIATIONS PROVISIONS
Agriculture, Rural Development, Food And Drug Administration, and Related Agencies, Commerce, Justice, Science, And Related Agencies, Department Of Defense, Energy And Water Development, Financial Services And General Government, Department Of Homeland Security Interior, Environment, And Related Agencies Departments Of Labor, Health And Human Services, And Education, And Related Agencies, Legislative Branch, Military Construction And Veterans Affairs And Related, Agencies, State, Foreign Operations, And Related Programs, Transportation, Housing And Urban Development, And Related Agencies, Health Information Technology, State Fiscal Stabilization Fund, Accountability And Transparency, General Provisions—This Act
DIVISION B—TAX, UNEMPLOYMENT, HEALTH, STATE FISCAL RELIEF, AND OTHER PROVISIONS.
Division 'B' Tax provisions—Assistance for unemployed workers and struggling families —Premium assistance for COBRA benefits. —Medicare and Medicaid health information technology; Miscellaneous Medicare provisions. —State fiscal relief. —Broadband technology opportunities program —Limits on Executive compensation.
TITLE IV—MEDICARE AND MEDICAID HEALTH INFORMATION TECHNOLOGY;MISCELLANEOUS MEDICARE
The integral portion of the legislation to implement EMR technology is PROVISIONS Meaningful Use is the legislative vehicle to fund The Health Information Technology for Economic and Clinical Health Act (HITECH) authorized incentive payments through Medicare and Medicaid to clinicians and hospitals when they use EHRs privately and securely to achieve the goals of ‘Meaningful Use’.
The Purpose of Meaningful Use:
1. Improve quality, safety, efficiency, and reduce health disparities.
2. Engage patients and families.
3. Improve care coordination.
4. Ensure adequate privacy and security protections for personal health information.
5. Improve population and public health.
Some of the Core Objectives for Meaningful Use (Stage 1) are as follows (these are three out of thirteen core objectives needed to be met by eligible professionals):
Use Computerized Provider Order Entry ([CPOE]) for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per State, local, and professional guideline [1]
Record all of the following demographics: (A) Preferred language (B) Gender (C) Race (D) Ethnicity (E) Date of birth (F) Date and preliminary cause of death in the event of mortality in the eligible hospital or CAH
Record and chart changes in the following vital signs: (A) Height (B) Weight (C) Blood pressure (D) Calculate and display body mass index (BMI) (E) Plot and display growth charts for children 2–20 years, including BMI
It is noteworthy to add that eligible professionals and hospitals have a different amount of core objectives and menu objectives that must be met in the Stage 1 of meaningful use. Eligible professionals must meet a total of 13 core objectives and 5 menu measures for a total of 18 objectives while eligible hospitals and Critical Access Hospitals must meet 11 core objectives and 5 menu measures for a total of 16 objectives to meet. Stage 2 of meaningful use Eligible providers must meet 17 core objectives and 3 menu measures for a total of 20 objectives while eligible hospitals must meet 16 core objectives and 3 menu measures for a total of 19 objectives. Stage 3 objectives is still being finalized and should be released in March of 2015.
The first stage of meaningful use, it seemed as if the government wanted eligible providers and hospitals to focus on implementation of EHR systems and collect certain patient data. Many hospitals and providers were still documenting on paper with little or no adoption of electronic health information implemented. Stage 2 of meaningful use seems to focus on how the data that is being collected is being used and disseminated. For instance, patients must now be able to view, transmit and download information regarding their hospital visit through a patient portal. This measure is all about patient involvement with their health information. Another focus for Stage 2 is intraoperability and the sharing of information with follow up providers. Many times when patients are admitted to a hospital their outside providers are never notified.
In essence, for ease of use and reference, it will be a good idea to summarize the various stages of Meaningful Use (MU) as, Stage-I - "Adoption" (of Electronic Medical Records), Stage-II "Exchange" (of data across EMR systems to make them interoperable) and Stage-III "Use of that data" (for Clinical Decision Support).
Total health care spending: $155.1 billion.
In her article dated 1/5/2015, on iHealthBeat.org, a daily publication of California Health Foundation, "12 experts weigh in on HIT progress, disappointments in 2014 and hopes for 2015", Kate Ackerman, Editor in Chief points out that [1]
"Incentive payments for eligible hospitals and professionals participating in the meaningful use program reached $25.7 B in 2014".
She goes on to add:
"According to ONC, more than 93% of eligible hospitals and 76% of eligible professionals now meaningfully use Health IT". [1] Although the 10 year Presidential mandate has included all three stages, we can reasonably infer that Stage-I - "Adoption" has been successful.
She also states that
"However, at the end of the year, CMS announced that more than 257,000 eligible professionals will be penalized in 2015 for failing to meet Medicare meaningful use requirements". [1]
This is a clear indication that, the Government, while willing and able to provide financial incentives for those that comply with this mandate, will also not hesitate to penalize those that don't comply, thereby making it both affordable and necessary for the well being of the society.
Health Information Technology
Medicare and Medicaid EHR Incentive Program will provide incentive payments to eligible professionals (EP), eligible hospitals (EH) and critical access hospitals (CAH) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology.
$25.8 billion for health information technology investments and incentive payments to physicians, hospitals and health care providers.
As enacted in 2009, mental health treatment facilities were excluded from the financial incentives available to most hospitals. The Behavioral Health Information Technology Act of 2011 extended the HITECH definition of “provider” and “facility” to include those for behavioral and mental health care. This incentivized proliferation of interoperable health information technology across psychiatric and primary health where continuity is vital. [2]
Resources
- ↑ 1.0 1.1 1.2 12 Experts Weigh In on Health IT Progress, Disappointment in 2014 & Hopes for 2015. January 5, 2015. http://www.ihealthbeat.org/insight/2015/12-experts-weigh-in-on-health-it-progress-disappointment-in-2014-hopes-for-2015
http://www.hhs.gov/recovery/overview/index.html
http://www.gpo.gov/fdsys/pkg/BILLS-111hr1enr/pdf/BILLS-111hr1enr.pdf
